A health facility in Mukuru kwa Reuben slum. FILE PHOTO | NMG
Nairobi’s informal
settlements of Kibera, Mukuru kwa Njenga, Mathare and Korogocho are home
to many of the city’s low-income residents. Though no formal statistics
exist on the distribution and number of our financially and socially
disenfranchised population percentages, those in the lower two wealth
quintiles make a significant number.
A recent tour of
the Korogocho settlement indicates the challenges the dwellers face not
just for other services, but also for healthcare needs.
Many
health service providers in such areas are likely not to be
professionals or licensed and services they offer are packaged with
cost-cutting as the main goal. This, often, leads to a huge compromise
on quality.
No single Level 4 facility exists in the area toured. Many services offered are by faith based non-profit entities.
As far as the quest for universal health care (UHC) goes, such
areas and residents need to receive an affirmative action in terms of
higher funding. How to design health approaches that ensure such groups
benefit from our UHC strategy is important. More so given the financial
and social disenfranchised nature of the group.
Unemployment
is high. Among young women and girls, the economic trappings place an
even higher hurdle for their escape from the poverty cycle.
With
the attendant low education, the possibility of such residents falling
off into crime and undesirable habits for young females, in particular,
is high. This, in return, has a subsequent impact on their maternal and
reproductive health outcomes over their lives.
What
are the needs of communities in informal settlements and how do we
decide how to allocate resources to meet them? Priorities tied to what
they require are important considerations.
With the UHC
team developing strategies, a priority funding for the preventative
aspects would best suit informal settlements. Otherwise risk exposure to
the funds would have a net loss.
A bottom-up holistic
approach is the best model and attempting to meet the health needs of
the community purely from a health care point of view is futile.
If any source of illness is to occur, informal settlements will serve as epicenters to the rest of the population.
Ultimately improving the housing situation followed by the infrastructure would also go a long way.
The Nairobi County health team must now second more health staff to such areas.
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